Provider Demographics
NPI:1417106618
Name:BUDWORTH, MELISHA ANNE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MELISHA
Middle Name:ANNE
Last Name:BUDWORTH
Suffix:
Gender:
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 384TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9637
Mailing Address - Country:US
Mailing Address - Phone:425-888-3348
Mailing Address - Fax:425-888-3347
Practice Address - Street 1:9050 384TH AVE SE
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9637
Practice Address - Country:US
Practice Address - Phone:425-888-3347
Practice Address - Fax:425-999-3348
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60032280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8079215Medicaid